Coorscreen: A Low-Cost, on-Site Mammography Screening Program

1996 ◽  
Vol 10 (5) ◽  
pp. 364-370 ◽  
Author(s):  
Mary Greenwood ◽  
Joanne Henritze
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Malignant Disease ◽  
Screening Program ◽  
Low Cost ◽  
Cost Savings ◽  
Participation Rate ◽  
Program Cost ◽  
Mammography Screening Program ◽  
Screening And Prevention

Setting. Coors Brewing Company is a self-insured corporation of 10,600 employees located in Golden, Colorado. Management has long believed in the value of a healthy workforce and has instituted ongoing health and wellness programming since 1981. Program design. Coorscreen was started in September 1985 to create an ongoing awareness of breast cancer screening and prevention for all female employees, spouses, and retirees and to lower the health care costs for the company through early detection of breast cancer. Program impact. From 1985 through 1993, 12,210 mammograms were completed on 3729 employees, spouses, and retirees. The participation rate was 83%. Forty-seven malignant conditions were confirmed during the first 8 years. Pathology reports confirmed 43 early detections (10 employees) and four late detections (two employees). The 10 cases of malignant disease detected early among employees cost an average of $12,388 in terms of direct medical costs, short-term disability, temporary replacement, and ongoing benefits. The two cases detected late among employees cost an average of $143,398. Among spouses, cases of malignant disease detected late have cost an average of $69,230 more than cases detected early. On the basis of early detection for 10 employees and 26 spouses, the total savings are estimated to be $3,110,000. Discussion. The Coorscreen program cost savings for the first 8 years were $3,110,080 because of the lower cost of early versus late detection. Total screening and procedural costs to the company have equaled $668,690. Thus the company has realized a total cost savings of $2,441,190.

scholarly journals Kuwait National Mammography Screening Program: outcomes of 5 years of screening in Kuwaiti women

2021 ◽  
Vol 41 (5) ◽  
pp. 257-267
Author(s):  
Hanaa Abdulla Alkhawari ◽  
Akram Mahmoud Asbeutah ◽  
Abdullah Abdulaziz Almajran ◽  
Latifa Abdullah AlKandari
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Mammography Screening ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Retention Rate ◽  
Lobular Carcinoma ◽  
Participation Rate ◽  
Program Outcomes ◽  
Mammography Screening Program

BACKGROUND: Breast cancer is the most common malignancy among women in Kuwait, representing 39.8% of all female cancer cases. OBJECTIVES: Report the data of the Kuwait National Mammography Screening Program (KNMSP) for a 5-year period. DESIGN: Prospective data collection. SETTING: Population-based screening. SUBJECTS AND METHODS: We included mammography screens done for Kuwaiti women (age 40 years and older) who attended the KNMSP from 2014 to 2019 to screen for breast cancer. A full-field digital mammography system was used to acquire the mammographic images in craniocaudal and mediolateral oblique projections. Independent double-blind reading of the mammograms was performed by two radiologists. MAIN OUTCOME MEASURE: Early detection of breast cancer. SAMPLE SIZE: 14 773 asymptomatic women met inclusion criteria (mean [SD] age, 51.8 (8.2). RESULTS: Lesions were detected in 551 women (3.7%). These included 233 malignant lesions (233/551, 42.3%), 57 high-risk lesions (10.3%) and 261 benign lesions (47.4%). The participation rate was 7.8% of the target population of women 40–69 years of age. The majority of breast cancer cases were reported in the age group 45–49 years (23.2%). The KNMSP study recall rate for 5 consecutive years was in a range of 11.9–16.5% (mean, 14.3%). The detection rate of ductal/lobular carcinoma in situ and invasive breast cancer were 2.5 and 13.6 per 1000 screened women, respectively. Invasive ductal carcinoma was the most common type. Only 4314 women followed up within 12–15 months of the first mammography for a retention rate of 29.2%. CONCLUSIONS: Screening mammography improves early detection of breast cancer in women older than 40 years but poor participation is a limitation. We are aiming to increase the participation rate to 70% of the population. LIMITATIONS: Lack of participation by women. CONFLICT OF INTEREST: None.

scholarly journals First Prospective Cross-Sectional Study on the Impact of Immigration Background and Education in Early Detection of Breast Cancer

Breast Care ◽  
2020 ◽  
pp. 1-7
Author(s):  
Elna Kuehnle ◽  
Wulf Siggelkow ◽  
Kristina Luebbe ◽  
Iris Schrader ◽  
Karl-Heinz Noeding ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
First Generation ◽  
Participation Rate ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
First Generation Immigrants ◽  
Cancer Early Detection

<b><i>Background:</i></b> Although immigrant health is an important issue in national health policy, there is a serious shortage of data in many countries. Most studies lack information on educational status, which is a major limitation. This prospective cross-sectional study analyzed a real-world breast cancer population on the influence of immigration background and educational status on participation in breast cancer early detection programs in the federal state of Lower Saxony, Germany. <b><i>Methods:</i></b> Data collection was conducted from 2012 to 2016 in six certified breast cancer centers using a standardized questionnaire for patients’ interview and tumor-specific data from the patients’ medical records. <b><i>Results:</i></b> 2,145/3,047 primary breast cancer cases were analyzed. 17.5% of our patients had a history of immigration, including <i>n</i> = 202 first-generation immigrants and <i>n</i> = 168 second-generation immigrants. Most of them were citizens of EU27 member states. No significant difference was seen in age, tumor stage, histology, grading, Ki-67, Her2/neu-status, and hormone receptor status compared to the native cohort. 100% participation rate in the breast cancer early detection programs were seen in patients with no school graduation. With regards to the national mammography screening program, participation decreased significantly with educational status (<i>p</i> = 0.0003). <b><i>Conclusions:</i></b> No tumor biological differences were seen between immigrants and German natives. In first-generation immigrants, early detection programs were well accepted despite sociocultural and language differences. Participation rate decreased significantly with higher education levels irrespective of country of origin. Immigration background does not have a negative effect on the participation in breast cancer screening. This mainly relates to immigrants from EU27 member states.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

scholarly journals Assessment of required resources for implementation of national breast cancer screening program in Serbia

2014 ◽  
Vol 142 (1-2) ◽  
pp. 59-66
Author(s):  
Nemanja Majstorovic ◽  
Snezana Simic ◽  
Bojana Matejic ◽  
Mladen Cudanov
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Economies Of Scale ◽  
Screening Program ◽  
Objective Assessment ◽  
National Program ◽  
Financial Feasibility ◽  
National Breast ◽  
The Republic ◽  
Radiology Technicians

Introduction. High values of standardized mortality and morbidity rates of standardized cancer mortality in Serbia, especially colorectal, cervical and breast cancer led to creation of national programs for their early detection and engagement of the international support for their implementation. Objective. Assessment of required resources (time, personnel, financial) to implement the National program for screening of breast cancer in the Republic of Serbia. Methods. Three possible scenarios have been prepared (optimistic, realistic and pessimistic) based on the expected coverage by screening of women aged 45 to 69 years, and time, personnel and financial feasibility estimates were made for a two-year screening cycle. Results. Time aspect of feasibility even under conditions of ?relaxation? of the assumption on the number of working days during the year did not question feasibility of any of the scenarios. Personnel feasibility is only possible in the pessimistic scenario, while the financial feasibility only makes sense in optimistic scenario as the least unfavorable solution due to economies of scale. Conclusion. Establishment of the initial base of skilled radiologists and radiology technicians and the system for their continuous medical education as well as allocation of specific MoH budget line for screening program expenditures, along with donated mammographs and good organization and coordination, may provide unobstructed implementation of the National program for early detection of breast cancer in the Republic of Serbia.

scholarly journals Clinical Breast Examination Campaign: Experience From Thiruvananthapuram, South India

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 137s-137s ◽  
Author(s):  
R. Jose ◽  
P. Augustine ◽  
A . Bindhu S ◽  
S. Rose Sebasitan ◽  
D. VA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Health Care Providers ◽  
Screening Program ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Care Providers ◽  
Regular Screening ◽  
Breast Awareness

Background and context: Thiruvananthapuram has the highest breast cancer incidence in India and majority of cases are detected late pointing to the inefficiency of early detection programs. Primary health care providers do not advise regarding regular screening and most women never resort to any screening practices. Mammogram is not cost-effective and clinical breast examination (CBE) is not popular as a screening modality in our population. Aim: To describe the conduct, utilization and outcome of mass screening program conducted in Thiruvananthapuram. Strategy: A mass screening program with media publicity to motivate organizations and residential associations was planned. CBE was conducted by one of the five lady doctors who were trained by an expert breast surgeon at a tertiary care center to detect suspicious lumps. All suspicious cases referred to experts who would further evaluate the cases at a clinic outside the tertiary care center. Advocacy and expert service at accessible sites and availability of expert service outside the tertiary care center at convenient timings improved the acceptance of screening. Intersectoral coordination, community participation, accessible expert services and appropriate technology were followed. Program/Policy process: 9942 women had CBE along with breast awareness in 101 camps over 66 days and it was probably “the first ever marathon breast cancer screening campaign” in the world. Sociodemographic variables, details regarding previous screening, breast symptoms and known risk factors were collected. Anyone with suspicious findings was referred to experts. Outcomes: 868 (8.73%) women with suspicious findings were referred to experts who advised 258 mammograms and confirmed breast cancer in 16 women (1.61 per 1000 women). Mean age was 45.46 years. 82.5% had screening for the first time. Uniformity in examination, three levels of screening and minimum utilization of diagnostic procedures makes this campaign distinct from others. All participants are kept on follow-up through a free clinic maintained by a nonprofit NGO in Thiruvananthapuram. Effective planning and selfless service along with coordinated effort of an apex institution (Regional Cancer Centre, Thiruvananthapuram), a private medical college (Sree Gokulam Medical College, Thiruvananthapuram) and media partners were the key to success. What was learned: Early detection of breast cancer is possible by CBE, provided women can be motivated for regular screening and adequate expertise is available. CBE campaigns can improve screening behavior and breast awareness among women. Primary health care providers and mass media could educate women regarding the benefits of breast awareness and motivate them for regular screening. Proper referral system including certified intermediate referral centers should be in place to ensure the success of early detection by CBE.

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